2012-11-14T07:55:19-06:00 2011-12-31 420714325 MCGLADREY LLP 801 NICOLLET MALL SUITE 1100 MINNEAPOLIS MN 55402 990 2011-01-01 270600894 MEDICA RESEARCH FOUNDATION MEDI 9529922058 401 CARLSON PARKWAY CP330 MINNETONKA MN 55305 AARON REYNOLDS 9529922058 2012-11-12 1 TODD A JACKSON P00092672 6123324300 2011 2016-02-24 21:20:13Z MEDICA RESEARCH INSTITUTE DAVID TILFORD 401 CARLSON PARKWAY CP330 MINNETONKA MN 55305 6515974 0 X N/A X 2009 MN THE MISSION OF MEDICA RESEARCH FOUNDATION IS TO CONDUCT RESEARCH THAT GENERATES INFORMATION FOR TIMELY TRANSLATION INTO ACTIVITIES, WHICH PROTECT HEALTH AND IMPROVE LIVES. 7 0 0 0 0 0 6500000 6500000 0 0 0 2010 0 13964 6500000 6515974 149999 61750 0 0 0 1082426 0 0 0 793398 494911 943397 1639087 5556603 4876887 9020974 13635117 533601 270857 8487373 13364260 THE PURPOSE OF MEDICA RESEARCH FOUNDATION IS TO PRODUCE GENERALIZABLE KNOWLEDGE FOR PUBLIC BENEFIT IN ALIGNMENT WITH OUR MISSION AND VISION. 0 0 61750 61750 13964 THE INSTITUTE GAVE A MONETARY CONTRIBUTION OF $50,000 TO THE MINNESOTA MEDICAL FOUNDATION IN SUPPORT OF A UNIVERSITY OF MINNESOTA DOCTORAL STUDENT. THIS STUDENT WAS NAMED AS THE FIRST MRI SCHOLAR AND WORKED ALONGSIDE INVESTIGATORS AT THE INSTITUTE TO GAIN VALUABLE EXPERIENCE IN APPLIED RESEARCH. THIS PROGRAM IS PART OF THE INSTITUTE'S COMMITMENT TO CONTRIBUTE TO THE EDUCATION OF THE NEXT GENERATION OF HEALTH SERVICES RESEARCHERS. THE REMAINING $11,750 WAS GIVEN TO SUPPORT THREE RESEARCH CONFERENCES: $5,000 TO MINNESOTA MEDICAL FOUNDATION'S "BRAIN SCIENCE: THE NEXT FRONTIER" CONFERENCE; $5,000 TO AMERICAN SOCIETY OF HEALTH ECONOMISTS' 4TH BIENNIAL CONFERENCE; $1,750 TO 16TH ANNUAL MINNESOTA HEALTH SERVICES RESEARCH CONFERENCE. 955676 DURING 2011 THE INSTITUTE HIRED FOUR DOCTORAL-LEVEL RESEARCHERS AND RECEIVED FOUR EXTRAMURAL RESEARCH AWARDS. AS A RESULT, COLLABORATIVE PARTNERSHIPS WERE FORMED WITH OTHER RESEARCH INSTITUTIONS IN THE REGION. THE INSTITUTE AIMS TO PUBLISH THE RESEARCH FINDINGS OF ALL FUNDED STUDIES AND SHARE THEM IN THE PUBLIC DOMAIN. 62583 THE INSTITUTE CONTINUED TO ADMINISTER ITS INTRAMURAL AWARDS PROGRAM (IAP), WHICH WAS INITIATED IN 2010. THE PROGRAM PROVIDED INSTITUTE INVESTIGATORS WITH THE OPPORTUNITY TO CONDUCT PILOT AND FEASIBILITY STUDIES USING INTERNAL RESOURCES AS WELL AS EXTERNAL CONSULTANTS. THE IAP IS INCLUDED IN THE INSTITUTE'S BUDGET AND HAS THE APPROVAL OF THE INSTITUTE'S BOARD OF DIRECTORS. 1080009 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 7 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MN X MARY QUIST 9529922058 401 CARLSON PARKWAY CP330 MINNETONKA MN 55305 DAVID TILFORD 40.00 X X 0 2223128 171530 CHARLES FAZIO 40.00 X X 0 641132 62078 JAMES JACOBSON 40.00 X X 0 553401 68830 AARON REYNOLDS 40.00 X X 0 1194598 114174 GLENN ANDIS 40.00 X 0 658334 83949 ROBERT LONGENDYKE 40.00 X 0 576176 74300 PATRICIA DENNIS 40.00 X 0 330938 56899 TIM THULL 40.00 X 0 374662 62119 KRISTINA BLOOMQUIST 40.00 X 0 119409 20089 0 6671778 713968 0 0 1 0 0 6500000 6500000 2010 2010 RESEARCH REVENUE 900099 13964 13964 13964 6515974 13964 0 2010 61750 61750 885041 632172 252869 126956 90683 36273 70429 50306 20123 1050 1050 333 333 170454 170454 635 635 1329 1329 20622 10311 10311 7000 7000 6048 6048 MEDICA ALLOCATIONS 277854 64333 213521 DUES, LICENSE & SUBSCRI 5428 5428 PUBLIC RELATIONS 2769 2769 RECRUITING EXPENSE 1338 1338 51 51 1639087 1080009 559078 0 9020974 13623018 12099 9020974 13635117 383602 182771 149999 88086 533601 270857 X 8487373 13364260 8487373 13364260 9020974 13635117 4876887 0 X 0 0 0 X X 0 0 0 MEDICA HEALTH PLANS 411242261 9 1 1 1 61750 1 61750 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 MINNESOTA MEDICAL FOUNDATION NW 5957 PO BOX 1450 MINNEAPOLIS MN 554855957 416007513 501(C)(3) 55000 $50,000 - SUPPORT FOR DOCTORAL STUDENT - NAMED THE FIRST "MRI SCHOLAR" TO WORK ALONGSIDE INVESTIGATORS AT THE INSTITUTE TO GAIN VALUABLE EXPERIENCE IN APPLIED RESEARCH. $5,000 - SUPPORT OF MENTAL HEALTH AWARENESS CONFERENCE. PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE INSTITUTE REQUIRES GRANT RECIPIENTS TO REGULARLY REPORT ON THE STATUS OF ALL GRANTS. ON A QUARTERLY BASIS, GRANT RECIPIENTS ARE REQUIRED TO SUBMIT A STATUS REPORT AND AN ACCOUNTING OF THE QUARTER'S EXPENDITURES AS COMPARED TO BUDGET. 0 1 0 0 0 0 1 0 0 DAVID TILFORD 0 716388 0 1355364 0 151376 0 160702 0 10828 0 2394658 0 0 CHARLES FAZIO 0 201387 0 390860 0 48885 0 54670 0 7408 0 703210 0 0 JAMES JACOBSON 0 255315 0 278150 0 19936 0 54968 0 13862 0 622231 0 0 AARON REYNOLDS 0 417853 0 685774 0 90971 0 100814 0 13360 0 1308772 0 0 GLENN ANDIS 0 270321 0 329280 0 58733 0 70053 0 13896 0 742283 0 0 ROBERT LONGENDYKE 0 250288 0 277552 0 48336 0 60297 0 14003 0 650476 0 0 PATRICIA DENNIS 0 169023 0 142049 0 19866 0 42529 0 14370 0 387837 0 0 TIM THULL 0 207206 0 149749 0 17707 0 47318 0 14801 0 436781 0 0 PART I, LINE 3 MEDICA RESEARCH FOUNDATION, THE FILING ORGANZATION, DOES NOT PAY COMPENSATION. ALL COMPENSATION IS PAID BY MEDICA HEALTH PLANS, A RELATED ORGANIZATION. WHEN ESTABLISHING COMPENSATION MEDICA HEALTH PLANS UTILIZES THE FOLLOWING; COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY/STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B THE FOLLOWING RECEIVED A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN PAYMENT FROM MEDICA HEALTH PLANS, A RELATED ORGANIZATION: DAVID TILFORD $44,254 AARON REYNOLDS $23,293 CHARLIE FAZIO $ 9,929 GLENN ANDIS $12,098 ROBERT LONGENDYKE $ 9,112 THE FOLLOWING PARTICIPATED IN, BUT DID NOT RECEIVE A PAYMENT, FROM A SUPPLEMENT NONQUALIFIED RETIREMENT PLAN FROM MEDICA HEALTH PLANS, A RELATED ORGANIZATION: JAMES JACOBSON PART I, LINE 6 MANAGEMENT INCENTIVE COMPENSATION INCLUDES COMPONENTS RELATED TO OPERATING EARNINGS OF MEDICA HEALTH PLANS. FORM 990, PART VI, SECTION B, LINE 11 MEDICA'S TAX ADVISORS COMPLETE THE RETURN, STAFF AT THE DIRECTOR LEVEL AND ABOVE IN BOTH MEDICA RESEARCH INSTITUTE AND MEDICA FINANCE DEPARTMENT REVIEW THE RETURN BEFORE IT IS SIGNED BY THE CFO. A COPY OF THE 990 WILL ALSO BE PRESENTED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C MEDICA'S GENERAL COUNSEL MONITORS THE ANNUAL COMPLETION OF ALL EMPLOYEES' CONFLICT OF INTEREST STATEMENTS. ALSO, AT THE BEGINNING AND THE END OF EACH RESEARCH STUDY, THE INSTITUTE'S RESEARCH COMPLIANCE MANAGER MONITORS COMPLETION OF CONFLICT OF INTEREST STATEMENTS FOR ALL PROJECT STAFF. SANCTION CHECKS ARE CONDUCTED ON ALL INSTITUTE EMPLOYEES UPON HIRE. CORRECTIVE ACTION IS TAKEN IF EMPLOYEES FAIL TO SUBMIT NECESSARY DISCLOSURES, INTENTIONALLY SUBMIT ERRONEOUS OR INACCURATE INFORMATION, OR FAIL TO ABIDE BY ANY CONFICT OF INTEREST STRATEGIES IMPOSED BY MEDICA'S GENERAL COUNSEL OR THE INSTITUTE'S RESEARCH COMPLIANCE MANAGER. FORM 990, PART VI, SECTION B, LINE 15 MEDICA RESEARCH FOUNDATION DOES NOT HAVE ANY EMPLOYEES. ALL COMPENSATION IS PAID BY MEDICA HEALTH PLANS, A RELATED ORGANZATION. MEDICA HEALTH PLANS USES THE FOLLOWING PROCESS TO DETERMINE COMPENSATION. THE PERSONNEL AND COMPENSATION COMMITTEE, AS DESCRIBED IN THE CHARTER, REVIEWS AND OBTAINS THE BOARD'S APPROVAL FOR TOTAL COMPENSATION FOR THE PRESIDENT/CEO. THE COMMITTEE ALSO REVIEWS AND APPROVES TOTAL COMPENSATION RECOMMENDATIONS MADE BY THE CEO FOR THE EXECUTIVE AND SENIOR VICE PRESIDENTS, AND REVIEWS ALL OFFICER COMPENSATION AND ANNUAL PERFORMANCE GOALS APPROVED BY THE CEO. THE COMMITTEE REVIEWS AND MAKES RECOMMENDATIONS TO THE BOARD REGARDING OFFICER AND NON-OFFICER COMPENSATION GUIDELINES FOR MEDICA AND ITS SUBSIDIARIES, PERIODICALLY REVIEWING MARKET DATA TO ASSESS MEDICA'S COMPETITIVE POSITION. OUTSIDE THE CHARTER, THE PERSONNEL AND COMPENSATION COMMITTEE WORKS WITH AN OUTSIDE CONSULTANT TO REVIEW MARKET DATA THAT AIDS IN SETTING COMPENSATION FOR MEDICA'S OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 ARTICLES AND BYLAWS, CONFLICT OF INTEREST POLICY, AND FORM 990S ARE AVAILABLE UPON REQUEST. AVERAGE HOURS PER WEEK FORM 990, PART VII, COLUMN B CERTAIN INDIVIDUALS REPORTED ON FORM 990, PART VII SPLIT THEIR TIME BETWEEN SEVERAL OF THE MEDICA ENTITIES (MEDICA HEALTH PLANS, MEDICA HEALTH PLANS WI, MEDICA FOUNDATION, AND MEDICA RESEARCH FOUNDATION). THE AVERAGE HOURS PER WEEK REPORTED IN PART VII ARE THE TOTAL HOURS PER WEEK FOR ALL FOUR MEDICA ORGANIZATIONS. MEDICA FOUNDATION 401 CARLSON PARKWAY MINNETONKA MN 55305 411812461 FOUNDATION MN 501(C)(3) TYPE II SUPORT ORG MEDICA HOLDING COMPANY 1 MEDICA HEALTH PLANS OF WI 401 CARLSON PARKWAY MINNETONKA MN 55305 411843804 HEALTH COVERAGE MN 501(C)(4) MEDICA HOLDING COMPANY 1 MEDICA HOLDING COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 010571840 HOLDING CO/NO ACTIVITY MN 501(C)(4) N/A 0 MEDICA HEALTH PLANS 401 CARLSON PARKWAY MINNETONKA MN 55305 411242261 HEALTH COVERAGE MN 501(C)(4) MEDICA HOLDING COMPANY 1 MEDICA INSURANCE COMPANY 401 CARLSON PARKWAY MINNETONKA MN 55305 411490988 HEALTH INSURANCE MN MEDICA AFFILIATED SERVICES C MEDICA SELF-INSURED 401 CARLSON PARKWAY MINNETONKA MN 55305 411479417 3RD PARTY ADMINISTRATOR MN MEDICA AFFILIATED SERVICES C MEDICA AFFILIATED SERVICES 401 CARLSON PARKWAY MINNETONKA MN 55305 411716415 HOLDING COMPANY MN MEDICA HOLDING COMPANY C MEDICA HEALTH MANAGEMENT 401 CARLSON PARKWAY MINNETONKA MN 55305 208005519 HEALTH MANAGEMENT MN MEDICA AFFILIATED SERVICES C 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 MEDICA HEALTH PLANS C 6500000 ACTUAL AMOUNT MEDICA HEALTH PLANS M 556328 ACTUAL AMOUNT MEDICA HEALTH PLANS N 1082426 ACTUAL AMOUNT